A psychiatrist is a physician, either an M.D. (Medical Doctor) or D.O. (Doctor of Osteopathic Medicine) who has demonstrated expertise in the field of psychiatry where they must prevent, diagnose, and treat mental illness.

To become a child, adolescent, and adult psychiatrist, one must go through 4 years of undergraduate study and 4 years of medical school. In medical school, one must pass all 3 USMLEs (United States Medical Licensing Examinations) or COMLEXs (The Comprehensive Osteopathic Medical Licensing Examinations). After medical school, one must apply and match into one of the residency programs. Most psychiatrists go through 4 years of residency. Then one would apply and match into a child & adolescent fellowship training and complete 2 additional years of rigorous training with long hours of work. In residency and fellowship training, it is not uncommon to work over 65 to 70 hours a week and be on call every 4-7 days. Upon finishing residency and fellowship, one must pass the psychiatry board exam and child & adolescent board exam by the American Board of Psychiatry and Neurology in order to be board- certified. Then, in order to maintain the board-certification, psychiatrists must keep up to date with the latest psychiatric knowledge.

Arizona, California, Connecticut, Nevada, New York, Oklahoma, and Texas. Patients must be physically located in one of these states. Of note, this is a telemedicine-only practice.

At this time, I do not complete documentation for FMLA or disability paperwork, school absences, work accommodations.

Due to federal regulations for prescribing of controlled substances over telemedicine (Ryan Haight Act), I do not prescribe any controlled medications at this time.

Examples of controlled medications are:

• Stimulants for ADHD such as Ritalin, Addrall, Vyvanse. Of note, I do discuss and provide non-stimulant options which may be helpful for ADHD. 

• Benzodiazepines such as Xanax , Ativan, Klonopin

• Sleep medications such as Ambien, Lunesta, and Sonata

Ripple Healthcare does accept insurance for adult patients for a limited time. Ripple healthcare does not participate with Medicare. We do not accept insurance for adolescent patients, so it is considered an out-of-network service. This allows for treatment to be more individualized.

Please check with your insurance carrier to see if they reimburse for out-of-network visits. If they do, I can provide you with an itemized statement to submit to them.

Psychiatric treatment can also be considered eligible for Flexible Spending Account (FSA) and Health Savings Account (HSA) reimbursement.

I recommend asking the following questions to your insurance carrier:

• What is my eligibility for out of network mental health/behavioral health outpatient, telepsychiatry care?

• How much will be covered for office visits with the CPT code of 90792 (initial evaluation by MD) and for 90833 + 99214 (individual therapy + med management)?

• Am I responsible for a certain amount of payment each year (deductible) before my insurance starts to cover payments?

• How many sessions are covered by my plan per calendar year?

What i do not currently provide care for:

• Emergency or crisis situations (suicidal or homicidal thinking, self-harm, or risk of harm to others)

• ADHD prescription of stimulant (therapy and non-stimulant med management are in scope)

• benzodiazepine prescriptions

• Active psychosis (hallucinations or delusions)

• Substance use in active medical detox

• Moderate to severe autism spectrum disorders

• Children under the age of 13 or adults over age 60